Provider Demographics
NPI:1922250992
Name:TRAN, VICTORIA THAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:THAO
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 W GREEN OAKS BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-2795
Mailing Address - Country:US
Mailing Address - Phone:817-446-1154
Mailing Address - Fax:
Practice Address - Street 1:3901 W GREEN OAKS BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-2795
Practice Address - Country:US
Practice Address - Phone:817-446-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572811223G0001X
TX25243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice